Medical coding audit helps healthcare providers enhance and implement correct clinical documentation processes. Effective audits have ensured the recovery of millions in improper payments in Medicare and other insurance schemes. In today’s competitive healthcare landscape healthcare organizations must have regular auditing practices in place to promote organizational transparency and employee performance. However, to witness the right outcomes, organizations need to partner with an experienced medical coding audit partner.

Outsource2india has over 24 years of experience in providing in handling the most complex coding file audits with absolute expertise and integrity. We specialize in end-to-end medical audits; from outpatient and inpatient procedures to behavioral and dental health treatments. We designate a qualified team to audit your files, create controls to catch and prevent mistakes and set up correct benchmarks for improvement. Our clients bank heavily on our understanding of codes and experience to make their healthcare processes compliant with regulations and save on expenses and time.

Medical Coding Audit Services

As an established medical coding audit services providing company, we provide a range of coding services to our clients. The most important services among them include –

Auditing Incorrect Use of CPT Codes

We audit CPT codes to determine if it has been improperly used. Issues arise at the time of unbundling, upcoding, improper reporting of time-based codes, using unlisted codes without documenting, failing to check National Correct Coding Initiative (NCCI) edits when reporting multiple codes. We look into each of these aspects during the review.

Auditing Right Place of Service

Many codes are to be used on claims to specify where services were rendered. Each payer has their place of service code. We audit codes to ensure there are no mistakes in the place of service. This ensures you do not get paid less for your services.

Auditing Incorrect Use of Modifiers/ Missing Modifiers

Improper use of modifiers can result in denial of claims. We audit files for missing or misplaced modifiers. Our modifier audits are carried out to tell payers that there were special circumstances regarding the provision of care. Our assessment of the correct use of modifiers is based on rules as well judgment.

Auditing Incorrect Diagnosis

When submitting claims for payment, the diagnosis codes reported with the service tells the payer as to why service was performed. The right codes help support the medical necessity of the procedure. We audit files to ensure the assigned codes correspond with the medical necessity. Likewise, we audit to ensure the diagnosis code for a patient is not changed to match the diagnosis codes listed in the coverage policy.

Auditing Correctness of Operative Reports

We audit operative reports ensuring there are no errors in the coding for post-operative diagnosis. We also make sure that coding for further defined diagnoses or extra diagnoses found in the operative report is complete and correct. Our task entails checking if the codes are the latest and are correct.

Auditing Documentation to Make It Apt For Procedure

We audit files to check if all the documentation leading to the procedure are correct. We check the files for the checkup reasons and related history, physical examination findings, and diagnostic test results, place of service, date and identity of the provider, clinical impression or diagnosis, plan for care etc. Our audit ensures there are no shortcomings in the documentation to cover the procedure.

Audit to Identify Bundling or Cluster Issues

Bundling codes need to be audited and understood well to ensure providers do not get paid less. We audit the single code that is used to replace the other codes to ensure the payment made under the single code covers all the basic costs of the procedure. We review files to ensure compliance with Local Medical Review Policy and National Correct Coding Initiative.

Provide Recommendations Based on Audit Findings

Our coding audit services also includes providing audit recommendation for correcting problems. Our audits take into account the cause of issues. Our recommendation involves documenting in details about the ways to fix the existing flaws and address the actual cause to eliminate recurrence of coding mistakes or failure to comply with laws and regulations.

Importance of Medical Coding Audit Services

When an organization chooses us to conduct a medical coding audit, it may have many reasons for doing so, ranging from efficiency to liability issues. Here are some of the top reasons organizations engage medical coding audit company –

• Eliminate Impressions of Fraud

During the process of coding, a lot of unwitting mistakes happen and in most of the times, they get interpreted as false representations. Such mistaken impressions can cause providers to get entangled in legal issues. Medical coding helps to eliminate such a possibility.

• Detect Coding Variations

Sometimes provider coding varies greatly from national averages. This can be a sign of an inherent and deep-rooted flaw in the system and can lead to huge revenue loss. The medical coding audit helps to measure the consistency of coded medical data. Timely detection of variation helps in improving coding quality and complying with federal guidelines.

• Identify Problems Early

Regular medical coding audits help to find problem areas early on in the process. Based on the audit findings providers can take appropriate corrective action. This way healthcare providers can stay safe from violating government rules and payer rules and inviting legal and penal actions.

• Remedy Under/Over coding

Sometimes outdated knowledge of coding can lead to undercoding, code overuse or poor unbundling habits. All this results in claims delay or denials or worse. Medical coding audits can help avoid these situations by nipping issues in the bud and help the provider stay compliant at all times.

• Uncover Reimbursement Deficits

A common issue with most healthcare providers is lost reimbursement opportunities due to reduced payments. Coding audits help uncover all reimbursement deficiencies and ensure there is no such repetition in future.

Why Medical Coding Audit Services to Corida Technologies?

As a reputed medical coding audit service provider, our audit services offer the following benefits to our clients –

• Lower Costs of Operations

  Appeals to medical denials are always a costly and time-consuming process. Our audits assist you to monitor your internal processes across a range of metrics and help you can gain a holistic view of the entire revenue cycle thereby reducing the need to spend money and time on countering denials.

• High-quality Audit to Lower Rate of Claim Denials and Rejections

  We assist our client’s lower rate of claim denials and rejections by categorizing and analysing them for issues that lead to errors. This helps put a complete check on improper coding and consequently helps in checking fewer payments and denials.

• Patient Data Security

  Being a top medical coding audit company, we make sure the data is highly secure. We are compliant with the ISO/IEC 27001:2022 standards and ensure the best protection to your data.

• Improve Compliance with Regulations And Coding Guidelines

  We audit files to ensure issues such as fraud, abuse, upcoding, unbundling etc. that lead to compliance violations are under complete check. We also ensure that issues like lack of documentation or documentation with errors are eliminated to comply with HIPAA rules.

• Meets Office of Inspector General Requirement (OIG)

  We assist our clients to establish compliance standards by developing a code of conduct consisting of written policies and procedures. The overarching objective is to assist employees to carry out their job responsibilities with perfection.

• Educate and Train Physicians And Other Coding Staff

  After the audit, we educate the staff on the flaws and ways to improve coding practices with proper checks and benchmarks in place. Our post-evaluation coding education entails teaching staff on modifier usage, CPT-4/ICD-9-CM coding, Mid-level provider coding etc.

• Scalable Services

  We offer ways to help you scale our solutions on demand. If you deal with bulk medical data coded and ready to be filed, we’ll will alleviate the workload.

• Quick Turnaround

   

  We believe agility is everything in medial coding audit performance. We work with medical coding audit tools and technology to accelerate the outcome.

• Experienced Medical Coding Auditors

  We have highly qualified auditors with rich experience in the medical coding framework. Our team includes professionals who have no less than 8 years of experience as an auditor.

• Reliable Customer Support

  You may contact our team of qualified medical coding support agents with whom you can keep in touch to get project updates or stay in touch.

Are you looking for accurate and error-free HCC medical coding services that will help you streamline your processes? Are you on the lookout for skilled and experienced HCC medical coding experts who can take care of all your requirements? Then, the best option for you would be to outsource HCC medical coding services to an experienced HCC medical coding service provider.

Outsource2india is one such HCC medical coding service providing company that can cater to all your needs with ease. We have some of the most experienced HCC medical coding experts who can take care of all your requirements with ease. We leverage the latest tools and technologies while delivering the best quality services to global clients.

HCC Medical Coding Services We Offer

Outsource2india has been a pioneer in providing the best quality HCC medical coding services to global clients for over two decades. We understand each client’s unique requirements and provide them with customized services that will suit their business requirements. Some of the key HCC medical billing and coding services we offer include –

Chart Review

Our team at Corida has the required skills and expertise to provide clients with accurate and focused chart review services for their HCC medical coding requirements. We leverage the latest tools and software to ensure that we deliver accurate services to clients at all times.

HCC Validation Services

Our team comprises some of the most experienced and skilled HCC medical coding experts who can cater to all your HCC validation requirements through RADV audits. We operate through several delivery locations which allows us to deliver accurate services to clients within a quick turnaround time.

Chart Audit Summary Reports

We make use of the latest HCC coding reporting tools and technologies o deliver the best and high-quality chart audit summary reports. We ensure that our team understands your requirements perfectly and delivers reports within a short time.

Embedded Codes Reporting

We have the required experience of working on some of the most popular medical coding software and provide clients with accurate reports of missing/embedded/suspect codes. We understand each customer’s unique needs and provide them with reports which will suit their requirements perfectly.

Why Choose Corida for HCC Medical Coding Services?

• Flexible Pricing Options

  We provide our clients with highly flexible and cost-effective pricing plans which will suit their budget and business requirements perfectly.

• Data Security

  Being an ISO/IEC 27001:2022 ISMS certified company, you can rest assured that all the data you share with us will be completely safe at all times.

• Best Infrastructure

  We understand the importance of having good infrastructure and have access to the latest tools and technologies along with the best workspaces.

• HIPAA Compliance

  We do not begin any project without signing the HIPAA agreement with eth client. This ensures that all patient-related data is safe at all times.

• Error-free Services

  Being an ISO certified firm, you can rest assured that all the services delivered by us will be of the best quality and completely error-free.

• SPOC

  When you choose to partner with us, we will assign a dedicated manager. This manager will be the SPOC for all your needs.

• Round the Clock Support

  Our teams including the sales, marketing, and customer support are available at all times to resolve any issues that you have.

• Experienced Team

  Our team comprises some of the most skilled and experienced HCC medical coding specialists who can cater to all your requirements.

• Highly Scalable Services

  Our team at O2I has the required bandwidth and resources to scale up the service requirements and team size as and when the client demands.

• Short Turnaround Time

  We operate through several delivery locations across the globe. This allows us to deliver the best quality services within a quick time.

Are you worried about the increasing number of pending claims and the accuracy of medical codes? Is the untimely reimbursement a cause of concern for you? An expert understanding of ICD-10 and CPT codes bring dramatic changeover in the way you get paid. It also clarifies disease management, simplifies research approach, and explains how to pursue public health.

Outsource2india is a leading medical coding service provider with almost two decades of healthcare support service experience. Our medical coders are proficient in documenting the patient’s medical state with an appropriate code, thereby leading to timely claim payments for your healthcare facility. Also, our medical coding quality and safety standards are risk-stratified. Outsourcing CPT and ICD-10 coding services to us will help you save time and boost your healthcare organization’s cash flow.

ICD-10 and CPT Coding Services We Offer

At Corida Technologies, we support you with CPT and ICD-10 coding services to help save your valuable time and successfully manage your medical coding requirements. When you work with us, you have access to our 100+ medical coders, 50+ AAPC-certified coders, and a facility that is compliant with HIPAA, HL7, and other major compliance regulations. You also get the best medical coding services which include –

• International Classification of Diseases (ICD) Coding

  This is a set of codes, maintained by the World Health Organization (WHO) and used in the healthcare industry to classify the various diseases and abnormalities. At Outsource2india, we have the required skills and experience to provide the required coding services for the following ICD-10 codes –

  • ICPM
  • ICD-9
  • ICD-9-CM
  • ICD-10
  • ICD-10-CA
  • ICD-10-CM

• Current Procedural Terminology (CPT) Coding

  CPT is a set of medical codes maintained by the American Medical Association to report medical, surgical, diagnostic procedures and services to physicians, medical insurance companies, and accreditation organizations. These codes are collectively used with ICD-9-CM or ICD-10-CM numerical diagnostic coding during the medical billing process. AT O2I, our team follows a validated procedure based on the CPT rulebook to assign appropriate CPT codes to patient’s healthcare diagnosis. We provide our coding services in the following CPT code categories –

  • Category I
    • Codes for evaluation and management
    • Codes for anesthesia
    • Codes for pathology and laboratory
    • Codes for surgery
    • Codes for medicine
    • Codes for radiology
  • Category II
    • Composite measures
    • Patient management
    • Patient history
    • Physical examination
    • Structural measures
    • Diagnostic/Screening processes
    • Patient safety
    • Therapeutic, preventive, or other interventions
    • Follow-up or other outcomes or results
  • Category III
    • Emerging Technologies
    • Procedures
    • Services

• Other Services

  Apart from the above-mentioned services, our team has the required skills and capabilities to provide the following services as well –

  • Patient statement preparation and revision
  • Translation of patient information into relevant codes
  • Insurance claims submission
  • Additional procedures and follow-up treatments information management
  • Charts and reports preparation and patient information organization
  • Follow-up with insurance companies for payments
  • Payment processing of payments received from insurance companies
  • Ensure healthcare organization has received all payments

Benefits of Outsourcing CPT and ICD-10 Coding to Corida Technologies

Corida Technologies has been a leading provider of ICD-10 and CPT coding services in India and have the required experience to provide quick and efficient medical coding services to clients across the globe. Have the medical billing and coding experience. Some of the key reasons for you to choose us include –

• Affordable Coding Services

  We follow some of the efficient medical coding processes which enable us to provide our clients with highly affordable medical coding services.

  We offer complete, accurate, and safe ICD-10 and CPT coding services that improve your performance and contain costs. This, in turn, will help you to forecast the healthcare needs & trend, analyze the associated costs, and reorganize your administration.

• HIPAA Compliant Services

  All our medical coding processes are HIPAA compliant and you can be assured that all your confidential patient data is completely secure with us.

• Data Security

  At Corida Technologies, we have established rigorous privacy, security, and confidentiality safeguards at each level of our department. We have established SOPs, regular and tailored training programs, Quality Assurance (QA) inspections, and sharing of best practices across the organization which helps us offer best medical coding services to you.

• Use of Latest Tools

  We make use of some of the best and latest medical coding tools to ensure that we provide our clients with the best quality and accurate coding services.

  We make use of ICD-10 compliant coding tools to ensure that you get the best and accurate coding services. Whatever might be the capacity of your healthcare organization, our team of expert medical coders make sure that every coding work is done securely and without obstruction.

• State-of-the-Infrastructure

  Our team of expert medical coders has access to some of the best infrastructure needed to provide you with the best quality medical coding services.

  Our multiple delivery centers are outfitted with the advanced infrastructure required to provide high-quality ICD-10 and CPT coding services. We have built-in IT redundancies, 200% power back up, firewall and intrusion detection technology, etc. Our high-end infrastructure reduces the chances of errors happening during the coding and billing process.

• Skilled Team of Medical Coders

  We have a team which comprises of the most talented, well-trained, and experienced ICD and CPT coders who can cater to any of your medical coding needs.

  At Corida Technologies, we have a healthcare & an insurance support team of 50+ experts. Our experienced ICD and CPT coders follow the mandated guidelines, which results in fewer claims getting rejected. Thus, you will see more timely payments and lesser denied claims to bother about appealing.

• Multiple Delivery Centers

  We have multiple delivery centers spread across the globe which enable us to provide the required medical coding services within a quick turnaround time

With the ever-changing health care regulations and strict policies put in place via government entities, clinical coding and analysis have become quite challenging. Inaccurate or incomplete submission of codes can result in a large number of claims being denied and underpayments, and cause disruptions and bottlenecks in coding workflows. This can leave you with unnecessary claim-related headaches and billing problems. Incorrect coding practices, out-of-date reporting methods, or even untrained coding personnel can damage the credibility of a clean claim. With our medical coding analysis services, we aim to minimize risk inside the billing process and streamline medical coding analysis strategies for the future.

Most organizations lack proper resources and enough expertise in medical coding analysis. This is why they choose to outsource medical coding analysis services to an experienced medical coding analysis services providing company like Outsource2india. O2I has a huge workforce, modern infrastructure, and international standard medical coding analysis services to provide efficient and quality output to clients.

Medical Coding Analysis Services We Offer

Corida Technologies  your medical coding analysis to Corida enables you to reduce compliance risks and optimize your revenue. We have a team of experts (radiology medical billing and coding analysis) that will improve your practice’s finances by streamlining submissions of claims and reducing the time and cost burden of administrative tasks. Our all-inclusive medical coding analysis is available as part of our full medical coding services. We ensure the highest degree of data integrity and match experienced coders to your operations.

We offer an entire set of varied medical coding analysis services, including –

• Revenue Cycle Management

  Corida provides and manages the entire RCM starting from an affected person’s admission to claims and debt settling. Disorderly claims and unsettled revenues are a few of the key difficulties that pull down the efficient performance of medical service providers. Some of the distinct advantages of outsourcing with Corida are accelerated revenue flow, organized and structured operation systems, and monitoring and analysis of revenues.

  By leveraging these benefits, you may streamline the operations at your health center or physician’s practice. In addition to this, Corida Technologies services include wise commercial enterprise decision help for value effectiveness, high excellent output, and reduction in workforce management. Our revenue cycle management solutions include –

  • Eligibility Verification
  • Patient Registration
  • Charge Capture
  • Medical Coding Analysis
  • Account Management
  • Medical Billing Analysis
  • Claims Review, Approval, and Repudiation Management

• Coding Estimation

  Our team of clinical coding experts consists of CPC and CCS skilled and certified scientific coders. O2I, a medical coding analysis services providing company, is focused on discounts in denials and in-turn ensuring you acquire the very best reimbursements.

EHR Integration

• Credentialing
• We help you through the procedure of being paid by using coverage vendors and moving into their networks. This consists of placing the fee agenda and helping with compensation from insurance companies.

Medical Coding Analysis Services Process We Follow

Corida Technologies offers open and honest medical coding analysis services because we want our clients to fully understand the procedure and have confidence in us. Having dealt with a wide range of needs, we have the best process flow to provide the best services and enable clients to make rapid money. The following steps are part of our five-tiered process flow for medical code analysis services. –

01. Receiving files

Use a dedicated, secure FTP connection to provide us scanned clinical statistics or impacted person charts. Moreover, we may get into your practice management system (PMS) remotely via a strong and secure VPN connection.

02. Pre-coding

In the second step of the medical coding analysis, codes for modifiers, coverage agencies, and referring physicians are input. Additionally, our team of pre-coders precisely generates procedural and diagnostic codes that are not previously present in the device.

03. Coding

We recognize the value and importance of precise medical coding. We place a strong focus on quality and promise that there won’t be any mistakes. We have skilled coders on our medical coding team with an average tenure of five years. For information on medical coding requirements, the team of skilled licensed coders (CPC and CCS) consults LMRP, CPT Assistant, ICD-10-CM, and HCPCS Level II.

04. Quality Control

A certified senior coding team audits all documents to confirm the coded charts are correct and to eliminate any chance of claims being denied.

05. Submission of Coded Charts

The completed and verified coded charts are uploaded into the practice management system or returned to the issuer over a secure FTP channel. After completed, the daily logs are emailed to the client for their records.

Are you looking for ways to communicate the patient’s complexity? Are you on the lookout for skilled and experienced risk adjustment HCC coding experts who can cater to your needs? Then, the best option for you would be to outsource risk adjustment HCC coding services to an experienced and skilled risk adjustment HCC coding service provider.

Corida Technologies is one such provider of risk adjustment HCC coding services that can serve as your one-stop shop for all of your requirements. Our team comprises highly skilled risk adjustment HCC coding specialists who are capable of handling all your requirements. While providing excellent services, we make use of the most recent HCC risk adjustment instruments.

RISK Adjustment HCC Coding Services We Offer

Corida Technologies has been one of the leading providers of risk adjustment HCC coding services to clients around the globe for over two decades. We understand each customer’s specific requirements and provide them with services that are customized to their needs. Some of the key risk adjustment HCC coding services we offer include –

1. Risk Adjustment HCC Validation

Some of the most knowledgeable and adept risk adjustment HCC coding experts are on our team, and they can handle all of your HCC validation needs. We give error-free services while utilizing the newest tools and technology.

2. HCC Chart Review

We make use of the latest chart review software and tools to deliver the best quality HCC chart review services to our clients. Our services ensure that our clients attain high accuracy in the HCC coding processes within a short time.

3. Chart Audit Summary

We have the required skills and expertise to provide clients with accurate and timely chart audit summary services. We leverage the power of the latest and the best HCC risk adjustment tools while delivering top-notch services to our clients.

4.Codes Reporting

We make use of the latest tools and provide clients with accurate reporting of embedded/suspect/missing codes. We have the skills to understand each client’s unique business requirements and provide them with services that will go well with their needs.

Why Choose Corida for Risk Adjustment HCC Coding Services?

Corida risk adjustment HCC coding services to us can give you access to a series of benefits that you can take advantage of. Some of the key reasons for you to choose us as your risk adjustment HCC coding service providing company are listed here –

Flexible Pricing Options :-

        We provide our clients with highly flexible and cost-effective pricing plans which will suit their budget and business requirements perfectly.

HIPAA Compliance:-

We do not begin any project without signing the HIPAA agreement with the client. This ensures that all patient-related data is safe at all times.

Data Security:-

you can rest assured that all the data you share with us will be completely safe at all times.

Error-free Services:-

Being an ISO certified firm, you can rest assured that all the risk adjustment HCC coding services delivered by us will be of the best quality and completely error-free.

State-of-the-art Infrastructure:-

We understand the importance of having good infrastructure and have access to the latest tools and technologies along with the best workspaces.

Quick Turnaround Time:-

We operate through several delivery locations across the globe. This allows us to deliver the best quality risk adjustment HCC coding services within a quick time.

Round the Clock Support:-

Our teams including the sales, marketing, and customer support are available at all times to resolve any issues that you have.

SPOC:-

When you choose to partner with us, we will assign a dedicated manager. This manager will be the SPOC for all your needs.

Easily Scalable Services:-

Our team at Corida has the required bandwidth and resources to scale up the service requirements and team size as and when the client demands.

Experienced Resources:-

Our team comprises some of the most skilled and experienced risk adjustment HCC coding specialists who can cater to all your requirements.